Healthcare Provider Details

I. General information

NPI: 1508701806
Provider Name (Legal Business Name): CHESTNUT HILL REHABILITATION AND HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 E END BLVD
WILKES BARRE PA
18711-0576
US

IV. Provider business mailing address

229 ROUTE 70 STE 70
TOMS RIVER NJ
08755-1026
US

V. Phone/Fax

Practice location:
  • Phone: 570-826-1011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SHAI BERDUGO
Title or Position: MANAGER/RALLEY 2 LLC
Credential:
Phone: 732-730-7360